amended order

Date:
/
/ 201_
Institution name: _________________________________________________________________________
Order placed by: __________________________________ Phone: (
) ________ - ______________
Enduser’s name: _________________________________
) ________ - ______________
Phone: (
P.O. # ________________________________________ or Credit Card:  VISA  MasterCard  AmEx
Credit Card #
_ _ _ _ - _ _ _ _ - _ _ _ _ -
_ _ _ _
Exp. Date:
__ /__
Name on credit card:______________________________________ Billing Zip Code : _ _ _ _ _ -_ _ _ _
Security code ______
(Green=X1D2: FITC flow cytometry/fluorescein microscopy filter; Red=X2D2: PE flow cytometry/rhodamine microscopy filter)
Manufacturer’s Suggested U.S. Prices
Catalog #
Product Name
Cytotoxicity Assays and Reagents
PTL802-8
PanToxiLux™ (80 assays)
PTL-P2D2-8
PanToxiLux™-P2D2 (80 assays)
GTL702-8
GranToxiLux®–PLUS! (80 assays)
TFL-2
Target Fluorescent Label-2 (100 assays)
TFL-4
Target Fluorescent Label-4 (100 assays)
NFL-1
Nuclear Fluorescent Label (100 assays)
BTL-60
Cytotoxicity Assay Buffer (60 ml)
TCM-1L
Effector Cell Growth Medium (1 liter)
(CTL602-8
CyToxiLux®–PLUS! (80 assays)
Autophagy Substrates
LC3R1G-8
ATG4B-LC3-G1D2 (80 assays)
LC3R2G-8
ATG4B-LC3-G2D2 (80 assays)
Apoptosis (Caspases Substrataes)
A304R1G-8
PhiPhiLux®-G1D2 (80 assays)
A304R1G-5
PhiPhiLux®-G1D2 (50 assays)
A304R2G-8
PhiPhiLux®-G2D2 (80 assays)
A304R2G-5
PhiPhiLux®-G2D2 (50 assays)
CPL1R1E-5
CaspaLux®1-E1D2 (50 assays)
CPL1R2E-5
CaspaLux®1-E2D2 (50 assays)
CPL6R1J-5
CaspaLux®6-J1D2 (50 assays)
CPL6R2J-5
CaspaLux®6-J2D2 (50 assays)
CPL8R1L-5
CaspaLux®8-L1D2 (50 assays)
CPL8R2L-5
CaspaLux®8-L2D2 (50 assays)
CPL9R1M-5
CaspaLux®9-M1D2 (50 assays)
CPL9R2M-5
CaspaLux®9-M2D2 (50 assays)
Elastase Substrates
E102R1G-6
ElastoLux®-G1D2 (80 assays)
E102R2G-6
ElastoLux®-G2D2 (80 assays)
β-Secretase/Cathepsin D
CD102R1G-6
CaDiLux®-G1D2 (80 assays)
CD102R2G-6
CaDiLux®-G2D2 (80 assays)
Price
_$_
Quantity
$450
1
2
_____
_____
$495
1
2
_____
_____
$450
1
2
_____
_____
$125
1
2
_____
_____
$125
1
2
_____
_____
$125
1
2
_____
_____
$60
1
2
_____
_____
$125
1
2
_____
_____
Special order only, please call for pricing)
$600
$600
1
1
2
2
_____
_____
_____
_____
$600
$400
$600
$400
$400
$400
$400
$400
$400
$400
$400
$400
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
2
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
_____
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_____
$600
$600
1
1
2
2
_____
_____
_____
_____
$600
$600
1
1
2
2
_____
_____
_____
_____
Plus shipping and handling fee for up to 2 kits:
US: second day delivery; please inquire for cost of next day delivery
International: 2 to 4 business days delivery
For EU customers, please provide institution’s VAT number as duty and other taxes are the responsibility of the enduser
Total order (Add MD State sales tax of 6% if applicable)
$35
ca.$45-55
$_________
Payment by P.O.# from a foreign organization must be made with a check in U.S. dollars drawn on a bank located in the U.S. or by wire transfer.
Payment in U.S. dollars drawn from a bank located outside the U.S. requires an additional fee of $50.
Billing address:
Shipping Address:
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
__________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
207A Perry Parkway, Suite 6
Gaithersburg, MD 20877
V: 301-987-7881
F: 301-987-7882
[email protected]
www.PhiPhiLux.com